Ten steps to fix eczema/dermatitis

This is what Luke’s mum told to me last week in my Clinic. She was getting desperate because Luke was itching, scratching, his skin flaking off and bleeding at night. He was a mess.

So, I’ve just organised a set of blood tests. Hopefully I can sort him out. This will follow my ten steps to fix eczema/dermatitis.

How can we stop this baby getting eczema? She has beautiful skin now, but there is a strong family history of eczema. Her parents are worried about the future. What should they be feeding their baby? How can they protect her? Should they be avoiding anything? I did not expect to become an eczema doctor! I am a paediatric with specialty training and certification in gastroenterology and allergy. I had thought that the dermatology experts would have got the triggers to eczema sorted out by now. But surprisingly, it is my experience that most dermatologist generally deny any relationship between foods and skin disease.

Eczema and food allergy related says Dr Rodney Ford

Food and eczema/dermatitis are closely linked

I did not expect to become an eczema doctor! But because of my success with helping these children, more and more children get referred to me.

I am a paediatric specialist with certification in gastroenterology and allergy. I had thought that the dermatology experts (skin-disease doctors) would have got the triggers of eczema sorted out by now. But surprisingly, it has been my experience that dermatologist continue to deny any relationship between foods and skin disease.

The graph shows 11 studies looking at the relationship between food allergy and eczema. The top studies, by paediatric allergists, show over half of the children with eczema have food allergy as a trigger. The bottom studies, by dermatologist, show around 10% (1-in-10) have a food allergy. In my Clinic I test everyone for immediate and delayed allergy.

Ten steps to fix eczema/dermatitis

My clinic attracts large numbers of children (and some adults) who have been fighting eczema for years (or decades). They have used every moisturiser and steroid cream that is available – but they are still severely affected. Like Luke’s mum, they are desperate to feel comfortable in their skin. They have been categorically informed that foods/diet is not the answer.

However, I see the exact opposite. I see that 80% of chronic eczema is triggered by food allergy/intolerances. In older children, and in adults, this is most often from gluten.

The 10 strategies/steps that I use to sort out these eczema puzzles are:

1. Listen to the whole eczema story and work out any triggers; 2. Do skin-prick-tests to discover any immediate food allergy or environment allergy; 3. Order blood tests for immediate allergy and immune function (if warranted); 4. Get blood tests done for gluten sensitivity (depends on age); 5. Work out an appropriate, low food-allergen diet; 6. Deal with dust mites allergy and other environmental allergens; 7. Start probiotic treatment (to switch off allergy); 8. Consider if antihistamines are needed: for symptom relief and asthma prevention; 9. Review the use of moisturisers, soap substitutes and steroid creams;

10. Prevent eczema and asthma for future children (more about this later).